ABSTRACT
INTRODUCTION Clinicians and researchers working with elderly patients face a paradox. We know that depressive symptoms and disorders are a source of great emotional and physical suffering in the elderly, yet the origins of late-life depression are not well understood. Moreover, as Blazer and Hybels (1) put it, “Older adults appear to be at greater biologic vulnerability to depression, yet community surveys in Western societies have repeatedly documented a lower frequency of late-life depressive symptoms . . . [and] disorders. . .compared to midlife.” Indeed, prevalence figures vary from study to study, depending on criteria for “depression” and the population studied. In general, community studies have shown that about 25% of elderly persons report having depressive symptoms, but only about 5% meet full criteria for major depression. In settings that care for more compromised elders, such as medical hospitals and long-term care facilities, the rates of depression are higher (2).
